The Ventura County Grand Jury has called for independent oversight to make sure Ventura County Medical Center complies with federal rules for a discounted drug program.

The Ventura-based hospital and other health care facilities serving needy patients buy the drugs at significant discounts. Medicare and private insurers reimburse the institutions at higher rates, allowing the providers to keep the difference and pay for expanded patient services, officials said.

But recent federal audits showed VCMC and other providers had violated rules for the 340B program, resulting in repayments to the drug companies.

In a 2015 audit, the medical center was faulted for issues related to purchasing rules, dispensing of the outpatient drugs to ineligible patients and inventory control. Drug manufacturers may also have issued discounts both to VCMC and the Medi-Cal insurance program for low-income and disabled patients, resulting in duplicate discounts, county officials said.

The grand jury said total duplicative discounts exceeded $3 million, a figure VCMC Pharmacy Director Jason Arimura says is actually no higher than $2.1 million. But he agreed with the grand jury’s recommendation that a knowledgeable outside specialist shoud be brought in to help supervise VCMC’s internal corrections plan.

County officials had already decided to do that before the grand jury’s report was issued in late April, he said.

“I think it’s reasonable,” he said. “We are in the process of seeing what vendors are out there to provide those services.”

The debt has been a moving target over the years. Arimura said the liability was originally estimated at close to $15 million to $19 million, based on all drugs purchased through the program. Negotiations with drug makers, analysis by consultants and repayment of $861,000 have reduced the outstanding amount to about $1.4 million, he said.

Negotiations are underway with two drug makers for about $425,000 of the $1.4 million, but the companies owed the remainder have not responded to the county’s inquiries, the report stated.

The grand jury concluded that proper oversight did not exist prior to the federal audit conducted in 2015 but that the corrective action plan installed by managers “appears to have adequate safeguards” to prevent duplicate discounting. Jurors also called for “more critical” outside audits in addition to internal reviews.

Jurors said county officials should study management, staffing and operational changes to ensure that the program is operated without violations. They said a system should also be established to track how the savings from the discounted drugs are used.

The grand jury is a panel of county residents that investigate operations of local government. It has no enforcement powers, but requests responses from agencies that are examined.

Jurors sought responses from VCMC and the Ventura County Health Care Agency, which oversees the large system of hospitals and clinics.